Just keep swimming

I am not sure what I expected after surgery but I've had a rough time but I've been okay.  I've surrounded myself with the people I care about the most and the people that care about me the most and have tried to make the best out of everything.  I don't regret the surgery and I'm not sorry I had it, but I wish there were some things that were different.


Vitamins - What is recommended for RNY patients is two multivitamins a day plus three calcium citrates.  The chewable "bariatric"multivitamins are icky.  They are gritty, chalky, stink, and get stuck between my teeth and the taste of them lingers in your mouth and its just all kinds of nasty.  The opening of my pouch is the size of an M & M and so taking regular multivitamins are out as all of the ones I am aware of are huge.  So I went today and bought liquid multivitamins - which taste similar to the chewables but aren't AS bad.  I had to ask the pharmacist to help me find the calcium citrate - most of your calcium is calcium carbonate and not calcium citrate.  So anyway - the pharmacist found me some but they were huge.  He found me some "Petites" and they are just slightly bigger than an M & M.  I took two this afternoon and they seemed to go down okay.  So far, its after 1 am and they're still down. 


Pain - I had to come off of my NSAIDs (antiinflammatory meds).  If I have any pain in the future, the only over the counter anything I can take is Tylenol. 


Medication in general:  Everything bigger than an M & M has to be either in liquid form or crushed. 


Complications - The feet, the pain, the back, my left arm, the needle.  I never realized it would hurt so bad.

Infections - I got an infection in the biggest incision. 


Numbness/Nerve Compression - My back is still hurting deep and numb on the surface.  Its frustrating and the doc says it may be months before it gets any better.


Watching other people eat - It never bothered me before surgery but now, postop, it drives me insane. I hate to feel like I'm not included in family dinners but to be included and to be served jello while everyone else is eating meat and potatoes sucks.

I know everything is little and I really don't have anything to complain about and I know this was my choice, but making a change this big and trying to balance everything else in life is hard and the battle with my weight will be a constant struggle.  I just have to remember - just keep swimming.

Just Call Me "Complication Girl"

I was changing clothes last night to get into my jammies and I grabbed the bottom of my shirt to take it off and it was wet. I looked down and it was covered in blood.  I called for Johnny and my mom/sister. All came in and I laid back on the bed and Johnny was cleaning the blood to try to figure out where it was coming from and it was from the incision where he sutured the fascia of the muscle. The skin had opened and ruptured.  It was cloudy blood, which indicated to me an infection.  We cleaned and bandaged it back up and then had to make the decision of going to the E/R or wait for my surgeon the next morning.  I decided that I'd rather wait on my surgeon who knew me and not just let any Tom, Dick, or Harry poke and prod at me, not knowing my whole clinical condition and history.  I woke up in the middle of the night between four and five o'clock and the blood had flooded the bandage and had soiled/saturated my night gown.  I cleaned it up the best I could and put yet another bandage on it, this time with gauze rolled under it.  I called his office and his answering service told me at 7:30 that he'd want to see me at 9.  So I called about 10 til 9 and they said "oh he's in surgery and his first appointment is at 1".  So I changed the bandage again and piddled around waiting on 1 o'clock to get here.  I got there for my appointment and he told me it was infected (in which I was not shocked) and he numbed me up with shots of lidocaine, snipped out all of the sutures and opened the wound back up and packed it.  Now I'll have to pack the wound until it granulates out and forms fresh/healthy tissue. I go see him again in the morning at 9 am. Fortunately, he said it was one of the easier complications to treat and everything would be fine.  I was shocked though with my medical history of getting staph infections more  frequently than most that he would've put me on antibiotics but he didn't.  I guess antibiotics are more complicated with bypass patients, as they can't swallow anything bigger than a plain M & M and most of the antibiotics on the market are honkers! I'm pretty sore today where the sorest incision to start with has been manipulated and altered. Hopefully it'll be better tomorrow.

 

Re-post: More things I wish I knew before Gastric Bypass

http://www.realself.com/forum/12-before-gastric-bypass-surgery

12 Things I Wish I'd Known Before... Gastric Bypass Surgery

Posted 03 Dec 2010

1) Gastric bypass is not a quick fix

Gastric bypass surgery is the most popular of the WLS options. However, it is not a "get out of jail free" card. You still have a lot of work to do pre- and post-surgery. Most doctors require you to lose between 14lb to 42lb, quit smoking, start eating right and exercise. This is all before you have the surgery. Once your post-op you still have to exercise, eat right, take daily vitamins and minerals, and have regular consultations with your doctor.

2) Weight gain is possible, even after having a gastric bypass

As mentioned above, gastric bypass surgery is not a fix; it's a tool to help you overcome the situation you are in, but you have to control that tool. If you abuse your new "pouch" by not eating right, not taking your vitamins, not drinking water and not exercising then you will gain weight.

3) Dumping syndrome is very common

Dumping syndrome occurs when undigested food from the stomach rapidly enters the small bowel, which is not prepared to accommodate it. This is then rushed ("dumped") into the intestines with a lot of fluid. It doesn't happen to everyone but it is very common. You can stop this from happening by not eating high sugar, high fat foods and not drinking with meals.

4) Insurance won't always cover the cost of gastric bypass surgery

Insurance companies use the NIH (National Institutes of Health) guidelines when considering whether or not to support weight loss surgery. However, it is not all based on weight alone. If you have other risk factors that your obesity is causing, adding to or affecting, it may be possible to use this as supporting evidence for your insurance claim. Every insurance company works to different guidelines, so you should always check with your insurance company first.

5) Support groups are very useful

After having gastric bypass surgery you will start to see yourself differently. You may not recognize the person you look at it in the mirror and it can be a scary time. Support groups are an excellent way of connecting with people who have been through, or are going through, the same situation.

6) You will still have an appetite and a relationship with food, it will just be different

Each individual is different but for most it is about learning to eat all over again. Your appetite won't be gone, just changed. You'll learn to enjoy food because you like it and not because it's there. You'll choose somewhere to eat out based upon their standard of food and not how much they give you. Food will still be as fun and interesting as it was before, if you want it to be.

7) It is going to be difficult to drink the required amount of water

After gastric bypass surgery you will be expected to drink approximately 2 liters of water a day. When you have a pouch the size of an egg, that can be difficult. The best thing to do is to fill a sports bottle up and carry it with you all day. Sip regularly and keep topping it up.

8) Trying to get enough protein into a post-op diet can be difficult

Protein is a major part of any post-op diet. You have to make sure you get enough -- if not you will start feeling ill. It can also affect your eyesight and hair growth, among many other things. Most post-op patients use protein powders to make shakes or even use them in cooking and baking.

9) One day you will plateau

You can not continue to lose weight forever. Your body may stop losing weight ("plateau") long before you are ready for that to happen. This happens to most people and can be rectified by changing your diet, your exercise routine or something else that has changed or slipped. Talk to your dietitian and doctor; they should be able to help you get back on the losing streak.

10) The pain will be worse than you imagined

Everyone is different and everyone handles pain differently. However, just because most gastric bypass surgeries are now done laproscopically, doesn't mean that you won't experience any pain. Your doctor is going to be drastically reducing the size of your stomach and cutting away the part that is not needed. That is going to cause some discomfort. You should be prepared for some pain and ensure your doctor talks through the procedure thoroughly with you.

11) Almost everything is psychological

For a lot of WLS patients, having gastric bypass surgery is less about losing weight and more about taking back their life. This is also one reason why many doctors request you see a psychologist prior to surgery. They need to make sure that you are fully aware of why you're having surgery and that your goals are realistic.

12) It is a hard journey but the highs are better than you could imagine

The WLS journey is not easy. It's hard work, takes dedication and can consume you for a time. However, fitting into those pants you haven't worn for 10 years, or shopping in "normal" shops, can give you such a burst of energy. Having people stop and tell you how good you look, going to a restaurant and not asking for a table instead of a booth, or going on a plane and not asking for an extender belt makes you feel better than you could have imagined.

Re-post: Things I wish I would've known before having gastric bypass

from http://www.gastricbypasstruth.com

WHAT I WISH I HAD KNOWN 

• I wish I had realized that my life would still revolve around food – or at least, what I ingest. Instead of being able to forget all about eating, my day consists of counting fluid ounces, protein grams and supplements.
• I wish I had known how difficult it would be to get all of the required fluids, proteins, and supplements in every day.
• I wish I had realized that gastric bypass surgery – and the ensuing weight loss – will not make all my problems go away. That I would still face issues even though I weighed less.
• I wish I had realized how this weight loss would change the relationships in my life – for better and for worse.
• I wish I had understood how incredibly traumatic it is to follow the liquid diet immediately after surgery, to see others eat and how I would feel excluded from things like family dinners.
• I wish I could have understood how it’s both liberating and frightening to be smaller.
• I really wish I could have seen how the sagging skin and remaining fat would look, and how self-conscious it would make me continue to feel.
• I wish someone could have gotten it through my head that I would still have to work at weight loss.
• I wish I would have known that my weight loss would make others feel uncomfortable and self conscious about their own weight and therefore they’d want to lash out at me.
• I wish I had realized that complications can happen to me and that those complications can be very unpleasant.
• I wish I had known how my attitudes toward food would change, and how unpleasant it would become to watch others shovel too much food in.
• I wish I had known hwo my attitudes toward overweight people would change, and how strange it would feel to not be “part of the club” around them.
• I wish I had known how easy it is to become obsessed with how I look, and how I would have to watch myself to make sure all my conversations didn’t revovle around me, my weight loss or my wrinkled skin.
• I wish I had known how invasive well-meaning people can be with their questions and how uncomfortable it would make me.
• I wish I had known that after 6-9 months the old demons of cravings and head hunger would rear their ugly heads and that eating right would not be easy or automatic.
• I wish I had known how horrible dumping really is, and how often it would happen to me after also having my gall bladder out.
• I wish I had known how frustrating it would be when I suddenly had loads of energy but my family didn’t, and how depressing it would be that all they wanted to do was watch tv.
• I wish I had known how sweet and understanding my husband would be and how difficult watching me lose weight while he didn’t would be for him. And I wish I had paid more attention to that during the first year, and thanked him more.
• I wish I had known what a relief it would be to interact with strangers and not feel they were judging me for being fat.
• Most of all, I wish I had realized that I’d still be “me” 100 pounds lighter.

None of the above would have been enough to change my mind. At least I don’t think so. I don’t regret my decision. But knowing them sure would have made the journey easier!

I hope it does that for you.

6 DAYS POSTOP

So lots has happened since I last checked in. I had my surgery and am still in the adjustment-transition period.  I was neurotic the week before surgery and did not get a single full night's rest the entire week.  I found myself tossing and turning and being wide awake at most hours of the night. The night before surgery, my mom told me I was "nesting", which she said was fine as long as I "didn't bring home a baby." I cannot explain why, but I just had this unsettled feeling about the whole thing. It wasn't fear, anxiety, or stress.  I had lots of questions, all of which were either answered by one of my doctors or other people in the support group. 

My surgeon was great and he didn't do anything wrong, but I did have a few complications, most of which were related to my size.  First off, let me say I was down 73 lbs the morning of surgery.  My goal weight from 513 was 445 and I weighed in at 440 in preop.  

Even with my drastic weight loss:

• The operation took six hours instead of two
• I had eight small incisions instead of the six anticipated
• I am having loads of pain and numbness
• My liver was "Floppy" and he had to use extra retractors to hold it back to operate on me.  If I had not have lost the weight preop, then he could not have done the surgery
• The OR table I was on was either too short or I was scooted too far down on it and my feet were pressed hard against the foot rest, so by the time I came out of the 6 hr surgery and preop and recovery, my feet were killing me.  They had me try to get up and walk but the soles of my feet were sore to the touch. They hurt to even touch the ground.
• He had to put more air in me for the laproscopic portion than most people to have the most room to work with possible, which means more gas to get out of my tissues later, which means you have to work the air out of your tissues by exercise, burping it out or tooting it out. Most of mine came from burping, which was incredibly painful but so it tooting postop. It hurts like hell too.  
• I ended up staying two nights in the hospital instead of one.  
• When he was using the curved stapler inside to create my pouch, it malfunctioned (from what i understand) and staple line busted out and he had to create a smaller pouch (approximately 1 oz instead of 2 oz) and its shaped a little different than most other RNY pouches. 
• While suturing the staple line, a curved sutural needle popped off into my abdomen and he couldn't find it.  They did an x-ray during surgery but didn't find anything.  My surgeon thinks it fell behind my spleen and when they got me up to walk after surgery, that it probably did fall to my pelvis or should fall to my pelvis and he said that scar tissue should form around it and it should not give me any problems.  I asked him if it would dissolve and he said no that it was surgical stainless steel.  I think knowing I have a needle stuck inside me is more of a mental issue with me rather than an actual medical issue. He said it happens to other surgeons all the time and their patients do fine, but I am the first one it has ever happened to for him and you could tell it really bothered him.  Its not that he's a bad surgeon at all - because he's not, he's excellent and the level of care he has for his patients is exponential to other surgeons I have encountered either through my job or having other operations myself. He didn't have to tell me and my family about the needle incident and didn't have to be up-front and honest about it, but he was.  He didn't try to talk to me about it while I was sedated or under any kind of anesthesia, he waited until around 9 pm that night to come back and discuss the complications with me when I was lucid and responsive.
• I finally got up to walk after surgery, but could only walk from the bed to the restroom.  I had a hard time trying to urinate.  I sat on the toilet for an hour the first time and just couldn't go.  (That was around 5:30-6:30 pm). My surgeon came back to see me later that evening and I told him about my not peeing issue and he said they put in a catheter during surgery and drained my bladder and he wasn't that worried about it because I was producing urine good during surgery, but if I didn't pee before 11 pm, for the nurses to go ahead and cath me again.  Let me be the first to tell you, at 10:45 pm, I was in that bathroom trying my best to pee. Finally at 10:58 pm, I peed.It wasn't like the dam  broke, it was just piddles here and there.  It burned and was bloody from all of the trauma I had been through that day.Since surgery, every time I have gone to pee, its at least a 15 min ordeal, if not an hour; they are incredibly painful.
• My surgeon told me before he released me that my bowels would probably lock up from the pain meds and nature of the surgery.  I had a BM the Saturday night before surgery and I finally had one post-op today.  So I went 8 days without one and it was incredibly painful and bloody.  I went to potty again this afternoon and I thought I had started my period in the middle of all of this (showing God does have a sense of humor) but no, was totally rectal bleeding.  Will call my surgeon in the morning to see when he can see me
• i had five iv's and I kept blowing veins. 

                                                                                                                                                                                                          
My pain level has went up since I came home and got off the morphine pump and they cut my hydrocodone syrup dose (which tastes like lemon pledge mixed with kerosene) in half with me coming home from 30 ml/6 hr to 15 ml/6 hr.  I had some left over morphine pills from a previous surgery that I had been hoarding until I needed them for emergency and believe me, this fit into that category.  

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